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Sparks HealthCare Clinic, LLC

Details

Name: Sparks HealthCare Clinic, LLC
Jurisdiction: Alabama
Legal type: Domestic Limited Liability Company
Status: Exists
Date of registration: 29 Nov 2021 (3 years ago) (Companies founded in November 2021)
Entity Number: 000-954-703
Register Number: 000954703
ZIP code: 35810 (Companies in Madison, 35810)
County: Madison
Place of Formation: Alabama
Registered Office Street Address: 3503 D NORTH MEMORIAL PARKWAYHUNTSVILLE, AL 35810

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1396498853 2022-02-03 2022-05-26 3503 MEMORIAL PKWY NW STE D, HUNTSVILLE, AL, 358102445, US 3503 MEMORIAL PKWY NW STE D, HUNTSVILLE, AL, 358102445, US

Contacts

Phone +1 205-442-6541

Authorized person

Name MARY E SPARKS
Role CRNP/OWNER
Phone 2054426541

Taxonomy

Taxonomy Code 261QH0100X - Health Service Clinic/Center
Is Primary No
Taxonomy Code 363LA2100X - Acute Care Nurse Practitioner
Is Primary No
Taxonomy Code 363LA2200X - Adult Health Nurse Practitioner
Is Primary Yes
Taxonomy Code 363LG0600X - Gerontology Nurse Practitioner
Is Primary No

Agent

Name Role
Sparks, Mary E Agent

Date of last update: 17 Aug 2024

Sources: Alabama Secretary of State